Provider Demographics
NPI:1770352247
Name:HARRIS, JUNENE K (AADP, IHPM)
Entity type:Individual
Prefix:
First Name:JUNENE
Middle Name:K
Last Name:HARRIS
Suffix:
Gender:F
Credentials:AADP, IHPM
Other - Prefix:
Other - First Name:JUNENE
Other - Middle Name:
Other - Last Name:K.
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:JUNENE K
Mailing Address - Street 1:1801 N HAMPTON RD STE 480
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-2391
Mailing Address - Country:US
Mailing Address - Phone:469-236-9147
Mailing Address - Fax:
Practice Address - Street 1:230 E BELT LINE RD
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-5704
Practice Address - Country:US
Practice Address - Phone:945-240-6989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-26
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach